A clinical nurse educator is auditing isolation practices and staff interventions across a medical-surgical floor. Which observed actions by the nursing staff indicate adherence to appropriate transmission-based precautions? Select all that apply.
- Assigning a client with suspected active pulmonary tuberculosis to a designated airborne infection isolation room (AIIR) and keeping the door tightly closed.Answer
- Putting on a standard surgical mask upon entry to the room of a client experiencing respiratory symptoms caused by Mycoplasma pneumoniae.Answer
- Securing a standard surgical mask over the mouth and nose of a client with confirmed pertussis who needs to leave the room for an essential computed tomography (CT) scan.Answer
- DCleansing hands with an alcohol-based antiseptic rub after emptying the bedpan of a client experiencing severe Clostridioides difficile diarrhea.
- EDirecting the unlicensed assistive personnel (UAP) to educate visiting family members on the contact precaution protocols required for vancomycin-resistant enterococci (VRE).
- FTaking off a fit-tested N95 respirator while still inside the isolation room of a client being treated for rubeola.
Answer
The correct actions include assigning the tuberculosis client to a closed AIIR, wearing a surgical mask for Mycoplasma pneumoniae, and applying a mask to the pertussis client during transport.
The correct actions demonstrate a thorough understanding of transmission-based precautions. Tuberculosis requires airborne precautions, meaning the client must be placed in a negative-pressure AIIR with the door tightly closed to prevent the escape of infectious droplet nuclei. Mycoplasma pneumoniae and pertussis are transmitted via large respiratory droplets, which requires healthcare workers to wear a standard surgical mask when in close contact, and necessitates that the client wear a surgical mask for source control when being transported outside of their assigned room.
Step-by-Step Solution
Key Concept
Standard and Transmission-Based Precautions